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Smoking ups risk of sudden death in women: report

A 30-year study of the effect of smoking on women's health reveals that even one cigarette a day can double a woman's risk for sudden cardiac death.

Photograph by: Pawel Dwulit
, THE CANADIAN PRESS

Even small amounts of smoking appears to nearly double a woman's risk of sudden cardiac death, researchers say.

Based on an analysis of more than 100,000 women enrolled in the massive U.S. Nurses' Health Study, the new study is one of the first to attempt to quantify how much, and how long, women have to smoke to increase their sudden death risk, and how soon after quitting smoking the risk of early death begins to drop.

Researchers found that "even small-to-moderate" amounts of cigarettes smoked daily - one to 14 per day - were associated with an almost two-fold increase in sudden death.

Not surprisingly, the longer women smoked the higher their risk. Every five years of continued smoking was associated with an eight-per-cent increase in sudden cardiac death, said lead author Dr. Roopinder Sandhu, a cardiac electrophys-iologist at the University of Alberta's Mazankowski Heart Institute in Edmonton.

Most sudden cardiac deaths occur in people without known heart disease. Abnormal heart rhythms are the most common cause. Unless an electric shock is delivered the person can die within minutes.

Nicotine may trigger life-threatening arrhythmias in several ways, Sandhu said. Nicotine can promote plaque build up in heart vessels and stimulate the release of epinephrine and norepinephrine, stress hormones that increase heart rate. It can decrease oxygen supply to the blood and make blood platelets stickier, increasing the risk of a blood clot.

For the study, researchers looked at the association between smoking and the risk of sudden cardiac death among 101,018 women who were free of known cardiovascular disease when the study began in 1980. Every two years the women, aged 30 to 55 at the study's start, received a followup questionnaire about their medical history, cardiovascular risk factors (including their current smoking status) and any newly diagnosed medical conditions.

During 30 years of followup, the researchers identified 351 women who had died of sudden cardiac death. Compared to those who had never smoked, smokers had a 2.44-fold increased risk of sudden death after researchers took known risk factors, such as age, diabetes, high blood pressure and high cholesterol into account. Women who reported smoking one to 14 cigarettes daily had a 1.84-fold increase in sudden cardiac death risk. The longer women smoked, the higher their risk: Women who smoked for more than 35 years were three times more likely to die during the followup than women who never smoked. For women who quit smoking, their risk dropped to that of non-smoker after 20 years of stopping.

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